居民驱动的临床决策支持治理,以提高临床决策支持的实用性
Kristin N Sheehan1, Anthony L Cioci1, Tomas M Lucioni1
1Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States.
住院团队成功优化了临床决策支持 (CDS) 警报,通过完善败血症,脂质资料和遥测的标准,大大提高了警报的有效性,减少了电子健康记录 (EHR) 中不必要的中断.
科学领域:
- 医疗信息学 医疗信息学
- 改善临床质量 改善临床质量
- 医学教育 医学教育
背景情况:
- 电子健康记录 (EHR) 中的临床决策支持 (CDS) 工具通常会出现错位,导致使用率低,警报疲劳.
- 启动了居民驱动的方法,以解决内部医学中的这些问题.
研究的目的:
- 识别和解决有助于利用率低下的麻烦CDS警报.
- 提高CDS战略的协调性和有效性.
主要方法:
- 一项内部调查确定了内科医生中最令人烦的CDS警报.
- 分析了电子健康记录 (EHR) 中关于CDS发射和响应率的数据.
- 根据"五项CDS权利"修改了警报标准,并提交给治理委员会批准和实施.
主要成果:
- 败血症警报,脂质资料提醒和遥测更新被确定为最麻烦的CDS警报,行动率低至1%.
- 有针对性的变化包括完善急诊室 (ED) 提供者的败血症警报,改进脂质资料提醒中的信息,并优化远程测量更新的时间.
- 这些干预措施导致了对内部医学提供者的ED性败血症CDS提醒的消除,脂质谱CDS发射率的97%降低,远程测量CDS发射率的55%降低.
结论:
- 居民领导的质量改进项目可以有效地优化中断警报.
- 强大的CDS治理策略对于成功的警报改进计划至关重要.
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